Babies are born with complete visual structures. However, at birth, they cannot see as well as older children or adults. Their eyes and visual system are not completely developed at birth and their vision continues to develop throughout their pre-school years.

– Noting that the period from birth through school age is critical for visual development. Any abnormality in this period can lead to permanent visual impairments.

– Recognizing that amblyopia (lazy eye) is the most common cause of visual impairment in children with a prevalence of about 2-2.6% in the U.S.1-2

– Noting that most vision conditions in children during the pre-school years cannot be determined on gross physical examination and may remain undiagnosed till children can read standard visual acuity charts around the age of 5.3

– Realizing that binocular visual impairment can lead to problems in motor and intellectual development.4-6

– Noting that the majority of pediatricians perform limited eye and vision exams.7

– Recognizing that the AAO, AAP, AAPOS, and the U.S. PHS emphasized on the need for eye screening in all children under age 3; those with amblyopia should be diagnosed and treated as early as possible.8-12

Therefore,

All children should undergo a regular complete eye exam at the ages of 6 months, 2 and 4 years.

Health care providers should be encouraged to educate parents on the importance of comprehensive eye exam.

Pediatricians should recommend all children receive a complete eye exam.

All schools districts in every state should require a complete eye and vision exam – just as they require up-to-date vaccinations – as a condition for completing a child’s registration therein.

AAO: American Academy of Ophthalmology, AAP: American Academy of Pediatrics, AAPOS: American Association for Pediatric ophthalmology and Strabismus, the U.S. PHS: public health services.

8. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Ophthalmology. Eye examination and vision screening in infants, children, and young adults. Pediatrics 1996; 98:153-7.

In 1996, the Defense of Marriage Act (DOMA) was signed into law that prohibits the United States government from recognizing marriage between individuals of the same-sex performed in territories, states and countries where it is legal. It further specifies that individual states are not obligated to recognize same-sex marriages that were performed in territories, states and countries where it is legal.

DOMA is a discriminatory policy that has substantial negative impact on the access to health care, as well as on the physical and mental health, of those in loving, committed same-sex marriages. While the National Organization for Marriage advocates for opposite-sex marriage only, they dismiss the needs of same-sex couples that would automatically be provided by legal marriage.

No other single policy in the United States has as broad-reaching discrimination against lesbian and gay couples as DOMA. DOMA should be repealed so that all married couples in the United States, irrespective of sexual orientation, are afforded spousal privileges under the law.

This May the WHO’s World Health Assembly passed a resolution (WHA64.9) specifically requesting the Director-General, “to convey to the United Nations Secretary-General the importance of universal health coverage (UHC) for discussion by a forthcoming session of the United Nations General Assembly.” This resolution reflects a growing commitment to target universal health coverage explicitly as a global development goal, and builds upon the work of the 2010 World Health Report on universal coverage.

This September, the Secretary-General (SG) should harness the lobbies and momentum of HIV/AIDS, Every Woman and Every Child, the Millennium Development Goals, and the nascent NCD movement, and transform them into an even more robust movement and strategic commitment to implementing universal health coverage. The SG has a unique opportunity to build on recent impressive successes in global health, and enshrine a path forward on UHC that every country can own.

Prenatal testing is very important for the health of newborn infants. Routine prenatal testing includes multiple blood tests that are related to the health of the mother and infant. Routine prenatal care includes testing for blood type and multiple tests for infection. These tests for infection include Hepatitis B, Syphilis, Rubella, and various cultures to detect bacterial infections such as urinary infections and Group B streptococcus infections. The current recommendations from the Centers of Disease Control and Prevention (CDC), American Academy of Pediatrics, and American Congress of Obstetricians and Gynecologists all recommend universal testing for Human Immunodeficiency Virus (HIV). HIV is a progressive chronic illness that may lead to early death and transmission can be prevented by medication therapy provided to the mother during pregnancy and delivery. Testing can be done with the other prenatal laboratory blood tests and does not require extra clinic appointments or procedures. Even with the above recommendations and almost 100% prevention of transmission of HIV to the infant, universal testing for HIV in pregnant women is not still routine. Some of this may be related to the stigma associated with HIV/AIDS. There are still cases of perinatal transmission (infection from mother to infant) in the United States. (See figure below from CDC website)

AIDS cases due to the perinatal transmission of HIV infection,

by year of diagnosis, 2001–2005, United States

Our mission is to obtain universal prenatal testing of all pregnant women for HIV in the state of California. We encourage all health care providers and hospitals to include HIV testing with routine antenatal testing. We also want to encourage all pregnant women to ask their physicians to provide testing for HIV.

Nigerians have now heaved a sigh of relief with the passage of the National healthcare bill. Several organizations including National council of women organizations (NCWS), market Women Association, International federation of women lawyers, Health reform foundation of Nigeria (HERFON) among others stormed the National Assembly as shown in the photograph demanding for the immediate passage of the bill. Most of these people are acting out of ignorance and poverty of knowledge thinking the solution to their entire health care problems lies with the passage of the bill.

This National health insurance scheme (NHIS) to me is an exercise in futility. It is like one of those elephant projects like the Ajaokuta Steel Mill that is usually embarkedupon by our inept leaders only to be abandoned mid way when it had already gulped billions of Naira. The national health bill comes with a very attractive package but how can the country sustain its funding in this era of high economic recession. Expecting a workforce of 25% to cater for 75% of the population is unrealistic. Also mal-distribution of health facilities between urban and rural areas where 90% of disease burdens are in the rural areas which has only 10% of health facilities, increased maternal and child health care relative to spending. The signs of failure are already ominous. After almost 10 years of operation, it has only covered less than 5% of 150 million people despite the huge amount of money that has been sunk there. Hence, the NHIS is not the “messiah” we are waiting for that will take care of our health care needs. It is a complete socialist ideology that will not survive in a capitalist and highly corrupt country like Nigeria. It faces the stark reality of failure. Some of those pushing for the passage of the bill already know but selfish-interest and corruption has blinded them. Nigeria is the second largest exporter of oil yet most of her citizens live below $1 a day. Poverty and diseases abound. Basic amenities are completely lacking. Health improvement is inextricably linked to other environmental, social, cultural and economic factors. Availability of basic amenities of life is related to good health.

I am totally in support of revamping Primary Health care (PHC) and increase its funding. Communities should be empowered to take care of their health problems. Community participation and ownershipshould be key to sustainability and self reliance in health development. Having practiced medicine in both rural and urban settings in Nigeria, I am very convinced that PHC still remains the cornerstone of health system development in Nigeria and the key to the attainment of Health for all Nigerians.

Newborn screening (NBS) has long been considered an invaluable tool in determining genetic disorders, so much so that all states in the US have mandated the test (though parents may refuse based on religious grounds). This was because the burden on society that would otherwise be shouldered, due to the cost of care and decreased quality of life, is significantly decreased with early diagnosis and treatment, much of which is facilitated by NBS.

The specimen itself, however, is not discarded after screening is completed. Rather it is stored at state health department facilities for various purposes. These include further research for disorders that may be added to the NBS panel and confirming patient identity (there are several interesting anecdotes about this). All samples are stripped of patient identifiers, though there is some information still tied to them, like the ethnicity or birth weight, since those factors are likely to influence any testing results.

Parents receive little education about NBS to begin with. So it is not surprising that they are unaware their children’s blood (and consequently DNA) is being kept for reasons other than the immediate one for which it was drawn. Moreover, informed consent is not obtained from parents to explicitly allow such storage.

Different groups of stakeholders, all with different invested interests in the matter, agree that informed consent is necessary. However, what each group means by this can vary greatly, from having NBS be an “opt-in” program to having parents sign an actual form to changing storage policies. Thus far, state health departments have been slow to respond, if at all, to this public concern.

It is suggested that a policy advocacy group be formed to propose viable solutions to address this issue. Ideally, solutions will encompass realistic goals for implementation, clear storage policy guidelines, and/or alternate recommendations based on other similar programs.

On December 2, 2010, Philadelphia City Council strengthened the law forbidding the sale of tobacco to minors. Today, City Council should go a few steps further in support of Mayor Nutter’s effort with legislation providing more funding for anti-smoking campaigns aimed at parents, children and the general public and banning smoking and the sale of tobacco in many child-friendly spaces.

In Uganda and most of Sub-Saharan Africa one in 35 women will die in childbirth, this statistic is over 1000 times higher a women risk in the industrialized world. Post-partum hemorrhage (PPH) accounts for the greatest percentage of excess maternal mortality. Oxytocin is an IV medication which is effective at decreasing PPH, but it is expensive medication and requires a cold chain for distribution. Misoprostol has a similar action and is available in a generic, stable pill form.

Oxytocin has an incremental benefit over Misoprostol, but is impractical in much of the developing world. The WHO’s recommendations demonstrate a failure to understand the realities of childbirth in sub-saharan africa or the undue influence of anti-abortion groups. Neither explanation appears adequate when considering the scope of the problem. Misoprostol is a medication that can promote primary health care now, and truly change the health and lives of women in Sub-Saharan Africa.

We have known for years that breastfeeding in the first year of life is extremely beneficial to the infant and the Mother. Breastfed infants are protected against ear infections, allergies, respiratory problems, diabetes, and have a boost in their immune system. Breastfeeding has been also shown to boost intelligence later in life, help with immunization responses in children, and reduce the risk of childhood obesity.

Studies show that women who breastfeed for at least six months to a year, have better postpartum recovery, better postpartum weight loss, have a lower chance of developing breast cancer, decreased risks of ovarian, uterine, and endometrial cancers, and lower occurrences of rheumatoid arthritis and osteoporosis.

Besides the health benefits the economic benefits of breastfeeding are astounding! The 2001 USDA report states that if current breastfeeding levels (29% at six months) were increased to the U.S. surgeon General recommended levels (50% at six months), a minimum of $3.6 billion would be saved!

The Bay Area is the hub of innovative technology and scientific research, housing both the Silicon Valley and Biotech Bay, boasting such companies like Google and Genentech. Hence the Bay Area is a great place to begin policy changes to promote childcare at the workplace. As part of a breastfeeding promotional campaign in the Bay Area, the California Department of Public Health should encourage state policy makers to offer tax relief for employers that offer childcare for their employees.

The second part of this campaign should focus on extending the California maternity leave so that mothers can breastfeed exclusively longer and devote more time and energy in establishing breastfeeding before returning to work.

Employers getting tax breaks for offering childcare will benefit the whole community. Mothers can establish breastfeeding while on maternity leave and once they return to work will be more likely to continue breastfeeding for the recommended six months and beyond since their childcare would be at work! The new childcare centers will also provide jobs for many in a state where unemployment is currently at a high 12.1%! Helping working mothers breastfeed is good for mothers and infants and it is good for the community!